Warner J P, King M, Blizard R, McClenahan Z, Tang S
Department of Old Age Psychiatry, Imperial College School of Medicine, St Charles Hospital, Exmoor St, London W10 6DZ, UK.
Br J Psychiatry. 2000 Oct;177:319-24. doi: 10.1192/bjp.177.4.319.
Few formalized shared care schemes exist within psychiatry and the evidence base for sharing psychiatric care is weak.
To evaluate the utility of patient-held shared care records for individuals with long-term mental illness.
Cluster-randomised controlled parallel-group 12-month trial involving 90 patients with long-term mental illness drawn from 28 general practices.
Carrying a shared care record had no significant effect on mental state or satisfaction with psychiatric services. Compared with controls, patients in the shared care group were no more likely to be admitted (relative risk 1.2, 95% CI 0.86-1.67) and attend clinic (relative risk 0.96, 95% CI 0.67-1.36) over the study period. Uptake of the shared care scheme was low by patients and professionals alike. Subjects with psychotic illness were significantly less likely to use their records (relative risk 0.51, 95% CI 0.27-0.99).
Patient-held records may not be helpful for patients with long-term mental illness.
精神病学领域中很少有正式的共享护理方案，且共享精神科护理的证据基础薄弱。
评估患者持有的共享护理记录对患有长期精神疾病患者的效用。
采用整群随机对照平行组12个月试验，涉及从28家普通诊所招募的90名患有长期精神疾病的患者。
持有共享护理记录对精神状态或对精神科服务的满意度没有显著影响。与对照组相比，在研究期间，共享护理组的患者住院可能性（相对风险1.2，95%置信区间0.86 - 1.67）和门诊就诊可能性（相对风险0.96，95%置信区间0.67 - 1.36）并不更高。患者和专业人员对共享护理方案的接受程度都很低。患有精神病性疾病的受试者使用其记录的可能性显著更低（相对风险0.51，95%置信区间0.27 - 0.99）。
患者持有的记录可能对患有长期精神疾病的患者没有帮助。
